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Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Lookup NU author(s): Dr Angela Bate, Professor Dame Louise Robinson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© This article is Open Access: CC BY license ( Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial. Aim: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact. Design & setting: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings. Method: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and ‘near misses’. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis. Conclusion: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.

Publication metadata

Author(s): Wheat H, Weston L, Oh TM, Morgan-Trimmer S, Ingram W, Griffiths S, Sheaff R, Clarkson P, Medina-Lara A, Musicha C, Spicer S, Ukoumunne O, Allgar V, Creanor S, Clark M, Quinn C, Gude A, McCabe R, Batool S, Smith L, Richards D, Shafi H, Warwick B, Lasrado R, Hussain B, Jones H, Dalkin S, Bate A, Sherriff I, Robinson L, Byng R

Publication type: Article

Publication status: Published

Journal: BJGP Open

Year: 2023

Volume: 7

Issue: 3

Print publication date: 01/09/2023

Online publication date: 19/09/2023

Acceptance date: 01/03/2023

Date deposited: 18/10/2023

ISSN (electronic): 2398-3795

Publisher: Royal College of General Practitioners


DOI: 10.3399/BJGPO.2023.0019

PubMed id: 37160337


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Funder referenceFunder name
National Institute for Health and Care Research
NIHR Applied Research Collaboration South West Peninsula (PenARC)
RP-PG-0217-20004National Institute for Health Research (NIHR)